[Correlation of clinico-neurological peculiarities and morphological signs of small hernias (protrusion) of the lumbar intervertebral discs in formation of discogenic pain syndromes in patients of different age].

Morphological signs of small hernias (protrusion) of intervertebral discs (IVD), the results of a neurovisualizing methods of investigation and clinico-neurological features of osteochondrosis as well, were summarized. In young and middle age patients morphological chatacteristics of small hernias (protrusion) of IVD, data of neurovisualizing methods of investigation have had correlated with clinico-neurological features of the disease and were the key determinants while performance of the puncture laser microdiscectomy. In a middle age and elderly patients a weak correlation was noted between the IVD protrusion dimensions and intensity of a lumbar and radicular pain syndromes, functional activity (Osvestry index), what have had permitted to apply a pathogenetically substantiated method of a durable epidural pharmacotherapy. The investigation results witness the necessity of differentiated application of the puncture methods of treatment for the pain discogenic syndromes in patients of different age.

[Percutaneous laser diskectomy in cervical osteochondrosis]. / Punktsionnaia lazernaia diskéktomiia pri sheinom osteokhondroze.

The paper presents early and late outcomes of treatment in 62 patients undergone paracentetic laser "diskectomy" for discogenic compressed syndromes of the neck. It shows the efficiency of surgery for radicular (92.9%) and myelopathic (92.8%) syndromes. Patients were selected for these interventions on the basis of clinical and neurological examinations, spondylography, MRI, and electric neuromyography. The main stages of an operation were as follows: local anesthesia, right-sided anterolateral access, X-ray guidance of the position of a needle, one-stage removal of herniated disks during multi-levelled injury during an intervention. The operation lasted 18 +/- 2.4 minutes. The mean hospital stay was 12 +/- 1.4 hours. The interventions were performed in 16 of 62 cases in the outpatient setting.

[The puncture laser dissectomy application for the discogenic lumbosacral radiculitis]. / Primenenie punktsionnoi lazernoi diskektomii po povodu diskogennogo poiasnichno-kresttsovoho radikulita.

The puncture laser discectomy was conducted in 273 patients with discogenic lumbosacral radiculitis while the conservative therapy inefficacy, pain syndrome in a lumbago stage present and lumboischialgia with absent prominent locomotive disorders and if the intervertebral disc hernia has the size up to 0.6 cm.

[The early diagnosis of combined craniocerebral injuries in elderly persons]. / Ranniaia diagnostika sochetannykh cherepno-mozgovykh povrezhdenii u lits pozhilogo vozrasta.

A study is presented of 212 elderly patients with associated head injuries. This type of trauma in the elderly is characterized by several features complicating its diagnosis. Knowledge of the anatomo-physiological aspects of the elderly and old, assessment of the injury mechanism, determination of the dominating and concomitant trauma, adequate use of adjunctive diagnostic methods are of importance in the choice of treatment tactics and in the improvement of treatment results.

[Prevention of intracranial hemorrhage in the postoperative period in severe cranio-cerebral trauma]. / Profilaktika vnutricherepnykh krovoizliianii v posleoperatsionnom periode pri tiazheloi.

An analysis of 463 patients operated upon for severe cranio-cerebral traumas has shown that one of the main factors improving results of treatment is using the methods of neurosurgical prophylactics of intracranial hemorrhages in the postoperative period. A considerably less incidence of intracranial hemorrhages can be achieved by using the inflow-outflow dialysis system, removing the crushed brain substance, suturing the dura mater to the periosteum at the borders of the bone defect. The ends of the ligature are taken out onto the skin through the holes in the center of the osseous flap.